Anterior cruciate ligament (ACL) injury is one of the most common knee injuries, especially in athletes who participate in high impact sports. Usually done on an outpatient basis, surgery for ACL injury involves reconstructing or repairing the ACL with the goal to create a stable knee by restoring the function of the torn ligament. Swelling and pain are common following ACL reconstruction. Recent research confirms that proper post-operative pain management improves patient satisfaction and function after the knee surgery.
The authors conducted a systematic literature review using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014). Up to 77 randomized controlled trials (RCTs) were included. Their findings are as follows:
- Single-injection femoral nerve blocks and intra-articular injections were an effective analgesic after the surgery.
- Cold compression therapy or cryotherapy compression was also beneficial, if intraarticular knee temperature reduced significantly with the application of ice and compression to the skin.
- Early weightbearing (the amount of weight a patient puts on the leg on which surgery has been performed) or mobilization decreased pain compared to delayed mobilization.
- Gabapentin, zolpidem, ketorolac, and ibuprofen decreased consumption of opioids or narcotic pain killers.
The researchers, however, concluded that further study is necessary to determine the best combination of modalities for recovery, while minimizing pain and opioid use.
These results are relevant for patients as well as physicians. In a professional pain management center in New York, health care experts utilize a combination of these techniques in knee injury treatment. In addition to these modalities, physical therapy is used to help patients regain strength, balance and movement control.